Purpose: To describe per- and postoperative complications which occurred with the first use of two automated microkeratomes for the performance of LASIK. Methods: Retrospective study of first surgeries performed with two automated microkeratomes. Seventy eyes from 54 patients using Chiron's® microkeratome, Automated Corneal Shaper (ACS) model, from April 1997 to April 1998 and 100 eyes from 82 patients using automated microkeratome Moria® Carriazo-Barraquer (CB), from February 1999 to June 1999. Refractive ablation was performed with the Summit Apex Plus Excimer Laser (193 nm). We evaluated the per- and postoperative complications up to one month of follow-up. Results: Photoablation was not performed in three cases (4.3%) using ACS microkeratome and in one case (1%) using CB microkeratome. Most frequent complications found with ACS were: failure of automated return of microkeratome (7.1%), partial keratotomy (4.3%), presence of stromal folds (14.3%), central de-epithelialization (4.3%). With CB there were: descentered flap (3%), central desepitheliazation (5%), stromal folds (28%) and Sahara Sands syndrome (6%). Conclusions: Initial use of both microkeratomes was related to important per- and postoperative complications, which did not lead to loss of vision. Clinical knowledge of the alterations which occurred with the use of these instruments and a better experience of their utilization may reduce these complications.
Keratomileusis; laser in situ; Keratectomy, photorefractive,excimer laser; Laser surgery; Microsurgery
